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Death Certificate - Sermershiem, Bernard_3/19/2001� LOCAL CERTIFIED CITY-COUNTY DEPARTMENT OF HEALTH : RECORD OF DEATH Ciiy o! Iivannvillc— Vanderburgh Coun�y 0 , � ' livansville, Indiana N- 19224 � i.�. = 1'his is to Ccrtify, that our rccards shnw------------------Ii�RAIF)BO_�$ALN$RSIIIEM.'---------- dicd ----APF2:CI�_lb.r197$------------- at -.6�30PM.---------------IlEZLCC1NE55------------------ mnn0� duy ycnr hour nf JenlL elrccl, hoepi4d ur rvrnl A�c at dcath 54 ---- Sc�___M_ALE__ Itacc__WIiITE-------------------MI�RRIED ---------------------------- y�o� _ ��.�mi amw. Yrimary causc oE dcath �;ivcn wa�?EPATIC FAILURE WITFI _IIEPATO RGNAL SYNDROME _______ --------------------- -------------------- ----101i'1'AL_ SSL��LGI. _ Sli llt�l Z.-IJ :�NN LC S_ _CI1t121iQ 5S5_ _W I1' LL _P�.liL'l�L. _ L1YP1::1�'I'1: NS I11N-- � . Si�;ncd by --,I2�__J _McES.ROY----------------------------°. �3L71NSVSZI.�,;LN--------------- . p nnr.�� ., }�.�{�� aa.��s 7 �'' Placc of burial or rcmoval__ ST. MARYS ____ _ HUNTINGBURG, IN. ------------------ --------------------------------- . �� nomc ol cemekry addre+v Datc of 13uriaL nPRIL_20� 1976 ___ SCIIMUTZLCR______. IIUNTINGIIURG,_IN. -- ----------- ------------- r� �.�i u�.«m. �,ia.��, Sig --- ��_'"_'��-1�---- -----�--��----Kcgistrar. Ev ille, Indiana ____ 3_ 13 _as__________ tsi=�r.� dob NOT�: Rccordcd locally in Iiook No. _ 41 __ Pagc No. _��___ Rcg. No. _��_ FEE ;2.Op �� ,, . , .